Evidence base: COPD

A summary of the clinical trials, guidelines and online resources to help in the management of COPD.

Cardiomyopathy may be a cause of heart failure (Photograph: SPL)
Cardiomyopathy may be a cause of heart failure (Photograph: SPL)
  

Clinical trials

This was a randomised, double-blind trial comparing a combination inhaler with placebo, salmeterol alone, or fluticasone propionate alone.

Compared with placebo, the combination regimen reduced the annual rate of exacerbations from 1.13 to 0.85 and improved health status and spirometric values (p <0.001 for all comparisons with placebo).

  • UPLIFT study. Tashkin DP, Celli B, Senn S et al for the UPLIFT Study Investigators. A 4-year trial of tiotropium in COPD. N Engl J Med 2008; 359: 1543-54.

In this study, the researchers investigated whether tiotropium attenuated the decline in FEV1 compared with placebo.

Mean absolute improvements in FEV1 in the tiotropium group were maintained throughout the trial (ranging from 87 to 103ml), compared with the placebo group (p <0.001).

At four years and 30 days, tiotropium was also found to be associated with a reduction in the risk of exacerbations, related hospitalisations and respiratory failure.

Contributed by Dr Simon Bourne, consultant in respiratory medicine, University Hospital Southampton NHS Foundation Trust.

Guidelines

Curriculum
This topic falls under section 15.8 of the GP curriculum Respiratory Problems.

Online


Contributed by Dr Simon Bourne, consultant in respiratory medicine, University Hospital Southampton NHS Foundation Trust


 


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